Some Things to Know Before You Consent
September 24, 2015
At some point in our lives, whether for ourselves or for a loved one, we are all faced with a decision whether or not to undergo a medical procedure. In emergency situations, doctors have broad powers to perform procedures necessary to save a life. However, when it comes to non-emergency situations and elective procedures, the doctor performing a procedure on your body must obtain your approval, or informed consent. In Pennsylvania, that means that whenever you have surgery, anesthesia, an insertion of a surgical device, radiation therapy or a blood transfusion, you have the right to know the important facts of the procedure, so you can make an educated decision about undergoing the treatment. Those facts include a description of the proposed treatment, the risks of the treatment and the viable alternatives to the proposed treatment. However, most people don’t really know what this means or what to ask of their doctor. Worse, yet many people simply acquiesce to anything their doctor suggests without question, virtually leaving the decision in the doctor’s hands. Here are a few tips to make sure that when the time comes, you are an informed consumer of medical services.
1. Knowledge is power. If you have the chance to research your condition and become knowledgeable about treatments and risks before meeting with the doctor, doing so will help you ask better and more insightful questions. Most good doctors welcome thoughtful questions from involved patients. This does not mean that everything you read on the internet is true and that you should discount any of your doctor’s advice in favor of what you read on the internet. To the contrary, use the available information to find out about problems, including the worst possible complications and the most common complications, that others may have experienced and ask about what can be done to avoid those issues.
If you don’t have the chance to research your condition and possible treatments and your condition is not imminently life threatening, do not sign the consent form during the same office visit where you learn you need an operation. For many, learning of the need for surgery is, deeply troubling and anxiety-ridden. Under those circumstances, paying attention to the doctor and giving thoughtful consideration while he/she explains the procedure or potential complications, in what likely sounds like a foreign language, and being engaged in the discussion is difficult. Ask the doctor for the chance to do some research and come back for a discussion about risks and potential complications. Ask if doing that will have an adverse impact on your surgery or recovery, though.
2. The Consent Form often gives someone other than your doctor the right to perform your surgery. This is especially true in teaching hospitals where residents obtain experience but it can happen anywhere. Usually, the consent form will authorize your surgeon by name along with verbiage like “and/or such other staff or resident physicians as my physician may designate to perform upon me.” Cross out any language that gives someone else the right to perform your surgery and initial the correction. Show the nurse or the doctor that only your doctor is allowed to perform the surgery. You chose your doctor for a reason. Why would you let someone that you don’t even know perform surgery on you? If an emergency that requires the talents of another surgeon arises during your procedure, consent to treat the emergent condition is not required. You have the right to refuse letting a resident develop his skills by practicing on your body.
3. Diplomas on the wall are no guarantee that he/she is the right doctor for the job. Don’t presume that just because your doctor suggests a procedure that he or she is the best one to perform it. Here in the Lancaster area, not only do we have local and regional doctors and hospitals, but we have access to doctors and hospitals from Baltimore and Philadelphia, too. Choosing a doctor or hospital for convenience is not a well-considered choice. Regardless from where you find your doctor, be inquisitive about the doctor’s expertise with the surgery proposed. You have the right to learn personal information about credentials, training and experience with the surgery. Ask how many of these specific surgeries your doctor has performed and find out the rate of complications. Ask questions about the worst complications he/she has experienced with the procedure and what are the most common complications. Ask about final outcomes. Ask about whether or not your own personal history or circumstances place you at a greater risk of complications. Just as importantly, though ask the doctor what precautions he usually takes and how he intends to protect you against those complications. Don’t be afraid to research second opinions to locate the best surgeon for you.
4. Make sure the Consent Form expressly identifies all the risks and complications discussed. Many patients sign consent forms that merely state that the nature and purpose of the procedure and the risks involved, side effects, complications, failure rates and alternative treatments have been fully explained. Often, the form does not specifically identify those risks and complications that were discussed with the physician. Cross out that language like “including but not limited to” and require the doctor to list the specific risks and complications of which he/she has notified you. If something on the list surprises you, make sure the doctor addresses it with you before you sign the form. Make sure that you and your doctor are on the same page and that you know and appreciate the risks before allowing him to perform the procedure on your body.
5. Ask your doctor about alternative ways to perform the surgery. Under Pennsylvania law, your doctor is not required to tell you about the different ways to perform a particular procedure. So, if there are other ways of doing the surgery, ask him if he does them or knows about them and why he proposes the technique he proposes. Remember, he/she has an incentive to perform your surgery. Also, don’t be fooled into thinking that “new,” means better. Just because a surgical technique or device is “new,” does not mean that it is the best for you. Unless a new device or new technique it has a verifiable track record of being safer for patients like you, make sure your doctor explains other options, too. Your doctor is not required to tell you about the different ways to perform the surgery, but you should be able to have an informed conversation about why he/she feels that the particular technique he/she proposes is best for you.
6. Just because you sign a consent form does not give the doctor the right to perform the procedure negligently. Many people mistakenly think that once they consent to the procedure, they give up their right to sue if something goes wrong. Signing the consent form does not affect your rights to hold the doctor accountable for violating safety rules. In fact, your consent has no bearing on claims that a doctor did something wrong before, during or after a procedure.
Remember This: It’s your right to be fully knowledgeable of the important facts so you can make an educated decision about what happens to your body.
For a printable copy of this article, click here.